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Wednesday, December 20, 2017

Medicaid in South Carolina

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for people with intellectual and developmental disabilities

South Carolina has low Medicaid reimbursement rates for ABA.  At The Post and Courier, Lauren Sausser reports:
Next year, this may change. S.C. Medicaid Director Joshua Baker wants to spend another $13.1 million during the 2018-2019 budget year to increase the reimbursement rate for ABA therapy from about $17 an hour to $24 an hour. If approved by the General Assembly, most of these new costs would be paid for by the federal government.

"What we’re committed to doing is monitoring the market and continuing to adjust our reimbursement," said Baker, who was named the new Medicaid director in November.

This increase is a step in the right direction, but it's not enough, said Lorri Unumb, vice president for state government affairs at Autism Speaks, a national advocacy group. Georgia, like North Carolina, also pays providers $50 an hour for Applied Behavior Analysis, she said.

"I think providers (in South Carolina) were hoping to get around the $40 mark," Unumb said. "I think we could do better, but I’m very appreciative that the state has taken note of the issue."
The state Medicaid agency is ushering in another big change this month. For years, children with autism in South Carolina only qualified for government benefits through a waiver program called the Pervasive Developmental Disorder Program.
But that program, administered by the S.C. Department of Disabilities and Special Needs, capped participation at 750 children at any given time. Hundreds of others who needed help were relegated to a waiting list.

Later this month, that waiver program will close. Any child diagnosed with autism who applies and qualifies for benefits will now receive them directly through the Medicaid agency.